Below-knee prosthesis suspension sleeve add-on

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HB Bk Sleeve Susp/Sealing

Payers reporting HCPCS L5685

Payer pricing summary

Low

$40

Average

$205

Median

$190

High

$436

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +20 other terms	377	$160	$169	$81	48%	—	$34 – $975
2	Aetna fee schedule · outpatient · +18 other terms	364	$159	$182	$85	47%	—	$55 – $1.0k
3	Humana fee schedule · outpatient · +17 other terms	321	$158	$235	$253	107%	—	$51 – $1.2k
4	Blue Cross Blue Shield fee schedule · outpatient · +17 other terms	237	$162	$210	$115	55%	—	$0 – $764
5	WellCare fee schedule · outpatient · +9 other terms	212	$163	$167	$27	16%	—	$34 – $300
6	Devoted fee schedule · outpatient · +5 other terms	165	$159	$159	$4	2%	—	$153 – $192
7	Molina fee schedule · outpatient · +11 other terms	144	$224	$213	$83	39%	—	$96 – $415
8	Cigna Healthspring fee schedule · outpatient · +3 other terms	116	$162	$162	$6	3%	—	$159 – $193
9	Cigna fee schedule · outpatient · +16 other terms	112	$163	$196	$95	49%	—	$55 – $1.0k
10	Anthem fee schedule · outpatient · +15 other terms	84	$156	$207	$188	91%	—	$81 – $1.2k
11	Kaiser fee schedule · outpatient · +13 other terms	68	$163	$239	$169	71%	—	$81 – $1.1k
12	Ambetter facility · fee schedule · outpatient · +6 other terms	45	$237	$280	$74	26%	—	$114 – $396
13	Caresource fee schedule · outpatient · +7 other terms	44	$159	$157	$39	25%	—	$72 – $244
14	Superior Healthplan fee schedule · outpatient · +1 other terms	40	$166	$166	$1	0%	—	$155 – $166
15	Clover fee schedule · outpatient · +3 other terms	37	$159	$160	$8	5%	—	$151 – $188
16	Oscar fee schedule · outpatient · +6 other terms	36	$167	$183	$39	21%	—	$155 – $267
17	Optum fee schedule · outpatient · +6 other terms	34	$159	$211	$83	39%	—	$152 – $396
18	Medica facility · fee schedule · outpatient · +8 other terms	22	$161	$148	$39	26%	—	$53 – $261
19	Medicare fee schedule · outpatient · +3 other terms	19	$153	$154	$2	1%	—	$148 – $156
20	Amerihealth Caritas fee schedule · outpatient · +3 other terms	18	$190	$185	$10	6%	—	$157 – $190
21	Bcbs Tx fee schedule · outpatient	18	$155	$155	—	—	—	$155 – $155
22	Regence facility · fee schedule · outpatient · +6 other terms	17	$166	$161	$12	8%	—	$128 – $169
23	Tricare facility · fee schedule · outpatient · +3 other terms	17	$154	$153	$4	3%	—	$139 – $156
24	Medical Mutual facility · fee schedule · outpatient · +2 other terms	15	$158	$182	$45	25%	—	$86 – $249
25	Highmark facility · fee schedule · outpatient · +7 other terms	14	$266	$263	$108	41%	—	$148 – $436

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